The present invention relates to a data processing system for use in a total medical image diagnosis which makes a proper combination of inspections of various types of medical images and sets up a proper order of executions of the inspections, and processes data on the result of the inspections.
In the recent years, X-ray CT (computed tomography) diagnostic devices have come into wide use. With this, more valuable medical images than those obtained by the conventional X-ray photographic diagnostic devices and the nuclear medicine diagnostic devices have been provided to remarkably improve the medical image diagnosis technology.
Four types of diagnostic devices provide different image information. The X-ray photographic medical image is two dimensional with a high accuracy, the CT medical image is anatomical and three dimensional, the ultrasonic medical image provides information effective for observing the soft part tissue and the motion tissue, and the nuclear medicine medical image is effective for studying the physiological function.
In the field of medical image diagnostic medicine, an increasing number of the different and further detailed information on the diagnosis is available, in addition to the medical image information provided by the above four imaging devices.
Recently, in addition to the X-ray CT, radiation emission CTs, using isotope, are being used, which have features of both the CT medical image and the nuclear medicine medical image.
An NMR (nuclear magnetic resonance) CT, recently attracting attention, has been studied and will be put into practice in a near future.
In the X-ray photographic diagnostic device, there are two photographies, a general (plain) photography and a cytography. In the cytography, there is established a plain cytography for digestive organs and many other special cytographies using catheter for the circulating system. These photographies provide many types of medical image information.
In digestive system diagnoses, microscopic medical image information with an endoscope using a gastorcamera, an endoscope television camera, is very important.
Diagnosis by thermography has frequently been used recently, in which a temperature distribution over the body surface is provided in the form of a medical image, and is used to find a disease.
To make a diagnostic judgement, a doctor studies the medical image information as mentioned above and selects desired medical image information from these pieces well suitable for diagnosing the disease.
Each type of medical image information has unique features as mentioned above. It is almost impossible, however, that an accurate and reliable diagnosis of a disease can be based solely on the information provided by a single specific medical image. To obtain a more accurate diagnosis, a so-called total medical image diagnosis has recently been proposed, in which different types of medical image information are combined for diagnosing one disease.
The total medical image diagnosis, however, involves two problems. One problem is deciding which valuable medical images must be selected from the many medical images, how to combine inspections of the medical images to obtain the medical image information, and in what order the inspections of the medical images must be executed. The other problem is how to obtain a more valuable composite information from the medical images. In connection with the former problem many clinical examples on specific diseases have been disclosed.
In performing the total medical image diagnosis, a so-called decision tree (D-T) describing routine procedural steps, as shown in FIG. 1, is frequently used. More particularly, a doctor anticipates a kind of a disease on the basis of the clinical data obtained by interviewing a patient, by biopsy, electrocardiogram etc. In this example the anticipated disease is pancreatic mass. In a level 1 of the medical image inspection, an X-ray medical image on a plain film is obtained. If the doctor is confident in a level 2 that the diseased part is normal or abnormal, the diagnosis process ends through only the level 1. When he can not determine whether it is normal or not, in the level 2, that is, when the diseased part is doubtful, a level 3 of the medical image inspection is executed. In the level 3, it is assumed that a size of the diseased part is found by the doctor below a border line size which is insufficient for exactly inspecting the diseased part, because the diseased part is very large. In this case, the doctor advances the inspection of the medical image to a level 4. In the level 4, ERCP (endoscopic retrograde cholangic pancreatography) is executed. In the level 3, also when a vascular tumor of 2 cm or more is found in the artery, the medical image inspection is advanced to the level 4. In the level 4, in this case, the arteriograph is taken to have an arteriogram. Further, when the examination in the level 3 shows that the diseased part is made of motion tissue and its medical image has a motion artifact to disable the inspection of the diseased part, the inspection advances to the level 4 where the ultrasonograph is taken.
The inspection system has a four level construction in which the inspection steps are classified into four levels. The inspection steps are advanced in the order of level 1, 2, 3 and 4. The inspection step of the level 1 is first applied to roughly determine what part is affected. Following the inspection of the level 1, the judgements are made in the levels 2 and 3. A proper inspection is carried out in the level 4 in accordance with the result of the judgements.
As described above, the doctor diagnoses by using a D-T to properly combine the medical image inspections.
However, there are many kinds of the medical image examinations requiring highly skilled techniques. In constructing or forming a D-T and executing the diagnosis on the basis of a D-T, complicated work for interrelating a large amount of information must be done. Further, for the combination of the medical image inspections and the order of the inspections in their execution, doctors have different views. Therefore, it is problematic and not practical to uniformly construct a D-T. In the data processing system for use in a total medical image diagnosis of the present invention, however, thoughts of respective doctors can be reflected with respect to an inspection of a diseased part.